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Zest for Life

THE MEDITERRANEAN ANTI-C ANCER DIET

1 ZestforLife 1 ZestforLife

Conner Middelmann-Whitney

This document contains extracts from Zest for Life, The Mediterranean Anti-Cancer Diet, a 280-page nutrition guide and cookery book with 150 recipes, published May 2011 by Honeybourne Publishing. The following pages include several excerpts of the book's 120-page science section followed by 12 sample recipes. Zest for Life can be purchased at all major bookstores, including www.amazon.com and www.barnesandnoble.com (US) and www.amazon.co.uk and www.waterstones.com (UK). It is also available as an electronic book on Kindle and other eBook outlets. This document is not intended for sale; it is available for free dissemination by anybody wishing to support the health of their patients, friends and loved ones. Copyright © 2011 Conner Middelmann-Whitney

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Introduction

Ten years ago I had a close brush with cancer. Diagnosed with cancerous lesions of the cervix, I decided to adopt a healthier lifestyle to support my medical treatment. However, I struggled to find reliable information and practical guidance to help me make the necessary changes. There is more information available now than a decade ago but much of it is confusing and not based on solid medical science. Moreover, while many cancerprevention books issue theoretical dietary recommendations, few provide guidance on practical ways of applying these in our busy day-to-day lives. This is why I decided to write this book. My first aim is to help you rediscover the guilt-free pleasure of eating healthy, delicious food. Many of us worry about the potential health risks of what we eat. With respect to highly processed factory foods, such fears may be justified. However, when healthy eating feels like a grim duty or a joyless medical prescription, I do not believe that it can fulfill its true objective. I say: Let's put pleasure back on the menu! When enjoying a varied diet of fresh, natural ingredients such as the one described in this book, don't be afraid of your food: savor it, have fun with it and celebrate it. It's the Mediterranean way. Let's also put common sense back on the menu. Adding turmeric to every dish we eat, or consuming a pound of raw cabbage daily because we have heard that it may be beneficial, isn't common sense. If anything, we should avoid repetitive, onedimensional diets; as we will see later, the healthiest diet is one that is rich in a wide variety of fresh, natural ingredients, carefully prepared and enjoyed with a positive and relaxed attitude. Alas, nutritional common sense has become rare. If we followed the advice of our great-grandmothers ("eat your greens," "eat breakfast like a king, lunch like a nobleman, supper like a pauper," "chew your food properly" and "don't snack between meals") the western world would probably not be plagued with cancer, heart disease, diabetes and obesity. So let's rediscover some of these ancient nourishing wisdoms: enjoying seasonal vegetables, putting a little more thought and time into what we consume, eating meals (rather than snacks) and enjoying these at dining tables instead of desks or cars, may just be some of the healthy habits worth rediscovering.

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Tasty advice based on nutritional science Zest for Life is a nutrition guide and cookbook in one. It aims to present the science of dietary cancer prevention and to show practical, enjoyable ways of integrating these findings into your daily life. It is the book I wanted when I was ill and that I am now making available to others wishing to prevent or overcome cancer. Sadly, most of us have experienced cancer, either first-hand or because a loved one, friend or acquaintance has been afflicted by the disease. However, many cancers are preventable and what we eat (and don't eat) significantly affects our risk of developing the disease, as we will see later. Chapters 2 to 4 discuss the link between food and cancer and the protective role of the Mediterranean diet. The research cited here is by no means definitive and further investigations are needed to shed more light on many unproven nutritional hypotheses. Alas, human intervention studies, the types of research that could yield the most useful results in the area of dietary cancer-prevention, are difficult. Not only are they long and costly, such investigations also involve ethical dilemmas. For testing foods on humans to assess their potentially harmful effects (for instance, high intakes of processed meats, or soy in women at risk of breast cancer) might damage the health of the people being studied. Uncertainty should not, however, prevent us from eating foods widely thought to have anti-cancer virtues, even if these have not been proven beyond doubt. Enjoying a wide variety of fresh, nourishing whole foods and avoiding nutrient-depleted, calorie-rich convenience products is likely to provide significant protection against cancer. Let's simply remember that there is no "miracle food" or nutrient that can prevent, let alone cure, cancer. This book is not only for cancer patients. It is aimed more generally at those who wish to boost their defenses against a disease that has taken on epidemic proportions: worldwide, approximately a third of all people will get cancer at one point in their lives and one quarter will die of the disease. Diet is not the only thing that affects our cancer risk. Among lifestyle factors that we can influence, regular physical activity is also crucial, as is maintaining a healthy body weight, avoiding tobacco and excess alcohol, carefully managing our exposure to sunlight and identifying and treating potentially cancer-causing infections. Genes matter too, though less than people think: an estimated 5-10% of cancer cases are thought to be due to inherited genetic predispositions to cancer.

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Environmental pollution and radiation are risk factors too, though unfortunately they are hard to avoid. Since this book concerns itself primarily with nutrition and cooking we will leave these factors aside; for more information on various lifestyle cancer protection measures, see Resources. The Mediterranean diet: delicious and nutritious If you want to start cooking immediately, go straight to Chapter 5 which suggests many practical ways in which busy people can obtain, prepare and enjoy healthy foods every day. This is followed by more than 150 recipes containing highly nutritious ingredients thought to have anti-cancer properties. They offer easy, delicious ways of eating the kinds of natural, fresh foods that our bodies thrive on. The recipes in this book are grounded in the traditional pre-industrial Mediterranean diet, a style of eating whose health benefits are supported by a vast body of research dating back to the 1950s. It is rich in protective plant foods and omits the highly processed foods that characterize the typical western diet. As research is increasingly showing, the Mediterranean diet may offer protection not only from cancer but also from cardiovascular disease, diabetes, obesity and even depression and dementia. Over and above merely biochemical considerations, the Mediterranean diet embodies freshness, diversity, simplicity, conviviality and joie de vivre. Healthy food should not feel like a punishment or a chore; if it does, we wouldn't eat that way for long. Thankfully, the Mediterranean diet requires no sacrifices and tastes delicious, as the worldwide popularity of Italian and French food attests. This means that we can eat it indefinitely, as an enjoyable, healthy lifestyle habit rather than a prescriptive, restrictive "diet." This book aims to show how life-affirming the Mediterranean way can be: shopping for seasonal ingredients, transforming them into tasty meals and savoring these consciously may in itself have therapeutic value, with positive ripple effects into other aspects of your life. This is why I have called the book Zest for Life: the title is not only a salute to one of my favorite anti-cancer ingredients, lemon zest, but also aims to awaken in readers feelings of energy, joyfulness and an appetite for life.

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Controlling the controllables Unfortunately, there is little we currently can do to reduce the cancer risks that may emanate from our genes, from environmental pollutants or from radiation. Therefore, we should do whatever we can to "control the controllables," that is, to make whatever healthy lifestyle changes are within our reach to help reduce our risk of developing cancer. The highly respected World Cancer Research Fund Global Network (WCRF), an international not-for-profit organization that includes the American Institute for Cancer Research (AICR) and that promotes cancer prevention through a healthy lifestyle, has produced a list of 10 recommendations for cancer prevention (opposite) based on an exhaustive analysis of the research into the link between diet and cancer which it published in its Expert Report in 2007. Check the list and see how many you already practice. Next, decide which additional measures you want to adopt and integrate them, one by one, into your life. This book should help you get there. Zest for Life supports cancer charities I am donating a portion of the proceeds from the sale of this book to charity (details regarding charitable donations can be found on the book's website: www. zestforlifediet.com). I also wish to state that in writing this book I did not receive any support ­ direct or indirect ­ from food companies, supplement manufacturers or anyone else who might have a commercial interest in cancer treatment and/ or prevention. That is not to say that I have worked in isolation. Notably the WCRF has been assisting my blog, the Anti-Cancer Challenge (www.zestforlifediet.com), by providing expert advice, and much of this information has made its way into this book. Moreover, to ensure that this book rests on solid scientific foundations, I have enlisted the advice of leading research scientists in the field of dietary cancer prevention and the Mediterranean diet. I am extremely grateful for their help; their work is cited throughout the book. Lastly, I have written this book using American spellings and terminology. For the avoidance of any misunderstandings, British and Australian terms are listed in a glossary at the back of the book, along with a metric/imperial conversion chart for measurements and temperatures. The recipes use both metric and imperial measurements.

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WCRF/AICRrecommendationsforcancerprevention

1. Beasleanaspossiblewithoutbecomingunderweight. 2. Bephysicallyactiveforatleast30minuteseveryday. 3. Limit consumption of energy-dense foods (foods that are high in fats and/oraddedsugarsand/orlowinfiber)andavoidsugarydrinks. 4. Eat more of a variety of vegetables, fruits, whole grains and legumes, suchasbeans. 5. Limitconsumptionofredmeats(suchasbeef,porkandlamb)andavoid processedmeats. 6. Ifconsumedatall,limitalcoholicdrinkstotwoperdayformenandone forwomen. 7. Limitconsumptionofsaltyfoodsandfoodsprocessedwithsalt(sodium). 8. Don'tusesupplementstoprotectagainstcancer. 9. Itisbestformotherstobreastfeedexclusivelyforuptosixmonthsand thentoaddotherliquidsandfoods.

10. After treatment, cancer survivors should follow the recommendations forcancerprevention. And, always remember ­ do not smoke or chew tobacco.

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The Mediterranean Diet

When I began writing this book I analyzed the eating habits I had adopted over the years ­ rich in vegetables, fruits, whole grains and nuts, high in olive oil and fatty fish, relatively low in red meat or dairy ­ and it struck me: without consciously intending to do so, I had adopted the traditional Mediterranean diet. The term "Mediterranean diet" has become a fashionable buzzword; yet, this way of eating has been around for millennia. Unlike many modern health-food regimes, the Mediterranean style of eating was not deliberately designed as a way to boost human health and longevity. Nor should it be seen as a "diet" for weight-loss. Rather, the Mediterranean diet is simply a traditional way of eating that evolved naturally, organically, in response to climatic and ecological conditions. The many different soils and micro-climates found in various parts of the Mediterranean basin have produced a high degree of variation among foods and flavors across the region. As a result, each area has its celebrated specialties: for example, herbs, olive oil and summer vegetables from Provence in southern France; ewes' milk cheese and olives from Greece; a multitude of vegetable antipasti from Italy; garlic, beans and almonds from Spain; pungent herbs and spices, beans and garbanzos, and a profusion of fresh and dried fruits from North Africa and the Middle East ­ to name only a few. Despite this wide diversity of flavors, ingredients and preparation methods, the region's traditional food patterns share many common traits. Because natural conditions were not particularly conducive to intensive animal husbandry, the inhabitants of the Mediterranean basin traditionally ate an abundance of plant foods: vegetables and fruits, weeds, roots and berries, nuts and seeds foraged in the wild, beans and legumes. Grains were consumed in their natural, unrefined state, mostly in the form of bread baked from whole, coarse barley or spelt flour, using sourdough as leavening, or as gruels cooked with water. Sugar was largely absent, processed food non-existent.

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A profusion of plant foods To this day, plant foods remain at the heart of the Mediterranean cuisine. Take a look at any Greek, Spanish, Lebanese or Italian restaurant menu. Here you can choose between salads of roasted bell peppers, onions and eggplant sprinkled with fresh herbs, or an antipasto of artichoke hearts marinated in olive oil. There may be Marinated mushrooms, chilled Gazpacho, Hummus or crunchy Garbanzo falafels nestling on a bed of crisp lettuce and doused with garlicky sesame sauce. For dessert, succulent figs stewed in red wine, baked peaches or, more simply, mixed nuts and dried fruits are on offer. With its heavy emphasis on plant foods, the pre-industrial Mediterranean diet was virtually vegetarian. This was reinforced by religious practices that dominated the region's eating habits until only two or three decades ago. Especially the Eastern Orthodox, Catholic and Armenian Churches limited or restricted meat: all animal foods ­ sometimes even eggs and dairy ­ were prohibited for forty days before Christmas and 10 days afterwards, the 40 days leading up to Easter, the 15 days before the Feast of the Assumption on August 15, as well as on every Wednesday and Friday of the year. What modest amounts of animal protein were eaten came mainly from wild fish caught in the sea, in rivers and lakes; from meager yields of goats' or ewes' milk used to make yogurt or cheese; from the eggs and flesh of chickens scratching around the yard, and from occasional goat meat, wild rabbits and game birds, such as geese, ducks, pheasant or quail, whose lean, aromatic flesh provided flavor to vegetable stews and soups. Wild, foraged animal foods like snails and frogs, an excellent source of healthy fats and protein, remain popular in France to this day. Pulling all these tasty and healthy ingredients together, olive oil has been the principal source of fat around the Mediterranean for thousands of years, prized for its rich flavor and high nutritional value. Further stimulating its eaters' taste buds, the region's diet has always made copious use of pungent garlic, aromatic herbs ­ oregano, thyme, parsley or fresh cilantro ­ and spices such as turmeric, ginger, cumin and coriander. You too can eat like a Mediterranean You may be wondering how you can adopt a Mediterranean diet without moving to Greece or Italy (albeit perhaps a tempting thought). The good news is: you can eat this way wherever you live!

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TheMediterraneandiet:top-10Features

1.Highintakeofvegetables and fruits 2.Highintakeof olive oil,moderateintakeofsaturatedanimalfats 3.Highintakeoflegumes (pulses), whole grains, nuts and seeds 4.Frequentuseofaromatic herbs and spices 5.Moderate-to-highintakeoffish and eggs 6.Moderateconsumptionofdairy products,mostlyascheeseandyogurt 7.Moderateintakeofmeatandmeatproducts,especiallyredmeat 8.Moderatewineconsumptionwithmeals(whereacceptedbyreligion) 9. Absenceofmass-producedprocessed food;lowintakeofsugar,refined flourproductsandindustriallyrefinedfats 10. Centralroleofconviviality:sharingfoodanddrinkwithothers

Based on ingredients that are easily available everywhere, simple to prepare and delicious, Mediterranean-style eating can be transported to any part of the globe and adapted to local conditions (seasons, types of vegetables and fruits grown there). Indeed, many adherents of the Mediterranean diet living in northern Europe, the U.S. or Australia are reaping its benefits daily. Sadly, one of the most reliable indicators of the healthiness of the Mediterranean diet is that when populations give up this style of eating, their health deteriorates markedly. Many citizens of modern-day Greece, Spain and Italy no longer eat the traditional Mediterranean diet, having replaced it with lower-quality fast food, and they're paying the price in terms of declining health, notably through a sharp increase in obesity.

Theoptimalcancer-preventiondiet

Over the millennia, the wide diversity in foods and flavors around the Mediterranean gave rise to markedly distinct and diverging culinary traditions. But what is striking is that almost every food thought to have anti-cancer properties ­ such as garlic,

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onions, cabbage, berries, green tea, mushrooms, olive oil, oily fish, nuts, seeds, lentils, aromatic herbs, spices and a wide and colorful range of fruit and vegetables ­ is an integral part of the traditional Mediterranean diet, no matter which region. From a purely biological perspective, in terms of the range and depth of nutrients it supplies, the pre-industrial Mediterranean diet is probably the closest thing to the optimal anti-cancer diet. It is unclear whether the Mediterranean diet actually prevents the formation of tumors or whether its protective role lies in hindering micro-tumors from developing into full-blown, life-threatening cancer. Whatever the mechanism, scientists estimate that up to 25% of colorectal cancers, 15% of breast cancers and 10% of prostate, pancreas, and endometrial cancers could be prevented if people living in the industrialized west did nothing more than adopt a Mediterranean diet. The more closely people adhere to the Mediterranean diet, the greater its anticancer effect is thought to be. According to a study conducted in Greece during the late 1990s, strict adherence to two elements of the Mediterranean diet ­ for example, a high consumption of vegetables and a low intake of meat ­ was found to bring about a 12% reduction in the incidence of all cancers. The more elements of the Mediterranean diet were incorporated, the greater their protection; thus, adhering to four elements ­ for instance, by adding a high intake of fruits and legumes to the two measures described above ­ might reduce cancer incidence by up to 24%. When combined with other healthy lifestyle habits, the Mediterranean style of eating may confer even greater protection. A large-scale European study conducted over 12 years showed that people eating a Mediterranean diet who hadn't smoked for 15 years or longer, undertook regular physical activity and drank a moderate amount of alcohol were 65% more likely to outlive those who had none of these healthy habits and were 60% less likely to die of cancer. The only controlled dietary investigation to date into the health effects of the Mediterranean diet yielded similar results. The Lyon Diet Heart Study indicated that eating a Mediterranean diet not only protected its 605 participants from cardiovascular disease, but also from cancer. Patients in the experimental group were encouraged to follow a regimen rich in fruits, vegetables and whole grains, to replace some meat with fish, to use healthy oils (especially omega-3 fats, see Chapter 3) and avoid unhealthy fats, and were allowed to drink moderate amounts of red wine with meals. After four years, they were found to be 61% less likely to develop cancer than members of the control group they were being compared to and who were eating the American Heart Association's so-called prudent diet!

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Is there a "secret ingredient"? For decades, scientists have debated passionately about what exactly it is about the Mediterranean diet that makes it so healthy. Is it the red wine? The olive oil? The high intake of vegetables? Garlic? Tomatoes or oily fish? An important protective factor of the Mediterranean diet is its high proportion of vegetables, fruits and legumes. In addition to vitamins, minerals and fiber, these plant foods contain bioactive substances called phyto-chemicals ("phyto" is the ancient Greek word for "plant") thought to protect us from a wide range of diseases, including cancer. While scientific evidence for the protective effects of vegetables and fruits is mixed ­ some studies show greater protection than others ­ a diet rich in unprocessed plant foods may well cut cancer risks, if only by crowding out the less-healthy foods we might otherwise eat. Vegetable and fruit consumption in many Mediterranean countries is higher than in many other western countries. Greeks eat up to 1¼ pounds (550 grams) of vegetables and 12 ounces (335 grams) of fruit each day. The vegetables most commonly eaten in Greece include lettuce, cabbage, wild greens, tomatoes, green beans, eggplant, artichokes, cucumber, onions, garlic and legumes (such as lentils, beans and garbanzos). Citrus fruits, apples, pears, peaches, melon, watermelon and cherries are among the most widely consumed fruits. By comparison, the average American eats 7¾ ounces (220 grams) of vegetables and 6 ounces (165 grams) of fruit each day. Potatoes (which are not actually vegetables, but starchy tubers) make up for 27% of U.S. "vegetable" consumption. Meanwhile, bananas, and oranges and apples in the form of juice are the most popular fruits in the US. Cultivated to be particularly sweet, none of these three fruits can be considered leading anti-cancer foods, especially once they have been processed into juice. Olive oil is thought to be another protective factor in the Mediterranean diet. Extravirgin cold-pressed olive oil contains compounds called antioxidants that are thought to protect the body's cells against cancer-causing agents (free radicals) and its stable chemical structure makes it suitable for cooking at moderate temperatures. The low meat intake characterizing the traditional Mediterranean diet may be another cancer-protective factor. Frequently eating red, processed or preserved meat is linked to cancer ­ especially colorectal, but also esophageal, lung, endometrial, stomach and pancreatic cancer. Conversely, eating fish ­ a popular source of protein in places like Spain, Italy and North Africa ­ may confer added protection. This is true especially of fish rich in omega-3 fatty acids, such as sardines, herring, mackerel and anchovies.

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A large European study recently found that people eating as little as three ounces (80 grams) of fish daily ­ just over half a typical tin of sardines ­ cut their colon cancer risk by 30% compared to those eating little or none. Meanwhile a regular intake of red and processed meats pointed to increased risks: those eating more than 5½ ounces (160 grams) daily had a 35% higher risk of colon cancer than those eating less than one ounce (20 grams). Variety really is the spice of life: food synergy While many individual foods traditionally consumed around the Mediterranean may have important cancer-protective characteristics, the benefits of the Mediterranean way of eating go well beyond the sum of its parts. It is the combination of these foods and their mutually reinforcing interaction that makes this diet so healthy. Scientists refer to this type of interaction as "food synergy," where one food reinforces the effects of another, providing greater health protection than if both foods were eaten separately. In the past, much nutritional research focused on the effect of individual food components ­ for example protein, fiber, or vitamin C ­ on human health. But isolated compounds studied under laboratory conditions do not behave the same way they do when obtained from whole foods, or when they are eaten in combination with each other. Many studies, for instance, have failed to show the health effects of fiber- or betacarotene supplements (indeed, some have found increased cancer risk in smokers taking beta-carotene supplements). This doesn't mean that fiber or beta-carotene aren't important for health, but rather, that they are most effective when consumed in combination with other nutrients. Thus, the benefits of the Mediterranean diet may lie not so much in the individual foods that constitute it, but in the fact that they are eaten together, in a wide variety of combinations and preparations: some raw, others cooked; some dried, some fermented, others marinated in olive oil or lemon juice; some grated, others whole; at different stages of ripeness and varying times of the day. Several studies have shown that eating a wide variety of healthy foods can protect us from a whole host of cancers, notably those of the digestive tract, from the mouth to the rectum, and from breast cancer. The health effect of a varied diet is most noticeable with vegetables and fruits; varying different types of meat or cereal grains does not appear to have noticeable benefits. (We will return to food synergy in Chapter 4.)

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Beyondmolecules:aMediterraneanfoodculture

So far, we have discussed only the biological factors that make the Mediterranean diet so healthy. However, over and above the foods that make up this diet, the region boasts a unique eating culture: it's not just what people eat, but also how they eat that distinguishes the Mediterranean way of eating from other food cultures. Regardless of regional differences and still relatively untouched by recent changes in eating habits, there remains an overarching Mediterranean food culture characterized by three key elements: variety, quality and conviviality. Variety, Quality & Conviviality: The Mediterranean Diet's "Holy Trinity" Variety A wide range of foods can be found on French, Italian or Spanish dinner tables, where a traditional meal might include vegetable soup or meat broth as an hors d'oeuvre followed by a mixed salad or a small portion of pasta, meat or fish and vegetables and rounded off by cheese or fruit. Each dish is modest in size but offers a vast array of nutrients. Quality The first thing you notice when visiting a French or Italian market is how discerning shoppers are when it comes to selecting their purchases. Limp lettuce, over-ripe apricots or lessthan-perfectly matured cheese will be cast aside. Shoppers do not hesitate to ask about the way the food was grown or to return purchases that were not up to their exacting standards. This insistence on quality ensures that the food on offer provides optimal nutrition and flavor. Conviviality The most life-affirming aspect of Mediterranean food culture is the central role of conviviality, the pleasure of sharing food with others and of celebrating communal culinary traditions and life at large. Without it, the Mediterranean diet would be just another biological health-food prescription; conviviality, at its heart, makes it a way of life. Conviviality, the missing link The word "convivial" comes from Latin, where it refers quite simply to the act of living together. We are drawn to conviviality by our human nature, our need for safety, companionship and comfort. Conviviality need not involve expensive ingredients or complicated preparations; the simplest village fête can be an occasion of unbridled revelry in food that is jointly

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prepared and eaten. France, for one, boasts countless gastronomic festivals at which whole villages or regions celebrate their local agricultural product, sometimes over several days. In Provence, the famous black Nyons olive is celebrated every January at a twoday event in the small town of Buis les Baronnies. The festival features a church blessing of the year's new oil crop, oil-tasting sessions, workshops teaching how to make tapenade, an aioli taste-off (aioli is a garlic mayonnaise) and much gaiety around the olive-pit spitting competition. On the Mediterranean coast near Marseilles, the fishing town of Martigues celebrates its seafood bounty every summer with so-called sardinades, regular events at which people grill and eat fresh sardines along the banks of the picturesque town's canals. Only five miles from my home in the south-west of France, the garlic-growing town of Cadours holds a three-day festival every August to celebrate its unique purple garlic. The event features garlic-peeling demonstrations, artfully woven garlic sculptures and the sale of home-preserved garlic in olive oil. Past festivals have featured raucous clove-spitting contests and the selection of a garlic queen ­ crowned, of course, with a wreath of garlic! The culinary high point of the Cadours garlic festival is the tourin à l'ail, a 40 gallon (150-litre) cauldron of garlic soup that is served ­ free of charge ­ to anyone who remembered to bring a soup bowl and spoon from home (and those who didn't are given disposable plastic tableware ­ no one is allowed to leave with an empty stomach). In the balmy evening air infused with the scent of garlic, strangers come together around trestle tables under the 200-year-old red-brick market hall, getting acquainted and sharing a laugh as they savor a simple meal of garlic soup, crusty bread and a glass of the local red. This celebration of the senses and the grateful, guilt-free acceptance of pleasure are typical of a Mediterranean meal. Taking time to prepare and savor our food consciously, without distraction or guilt, and, if possible, enjoying it with friends or loved ones, is one of the best things we can do for our health, both at a physical and an emotional level. When snacking replaces meals You don't need to leave your house or spend a lot of money to enjoy a moment of conviviality. All it takes is one person or more, a table, some chairs (even a picnic blanket will do) and some simple, tasty food.

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While this may seem like the obvious definition of a standard meal, the sad fact is that more and more people snack their way through the day and eat fewer and fewer sit-down meals. Even if you are on your own, sitting down to eat in a pleasant place (not in front of the TV or the computer) will encourage healthy eating and conviviality with yourself. A U.S. study found that among 18- to 50-year old Americans, roughly 20% of all meals are eaten in the car. According to the U.S. National Highway Traffic Safety Administration, in-car eating is a more dangerous distraction than using a hand-held mobile phone while driving. Consequently, U.S. insurer Hagerty Classic compiled a list of the 10 most dangerous foods to eat while driving: chocolate came in first place (a distraction as drivers wipe their sticky fingers), followed by spill-prone drinks, squirty jam- or cream-filled donuts and greasy fried chicken. Meanwhile in Britain, a growing number of meals are eaten in front of the TV, in the car or standing around the kitchen; only 37% of families eat most of their meals at a dinner table, according to one survey. Some 12% of respondents said they hardly ever eat with their family, and another 12% said they rarely speak during family mealtimes. One packaged gravy manufacturer even launched an advertising campaign to encourage British families to aspire to have one "proper" home-cooked meal together ­ per week! When they do eat a meal, most people rush through it. The average British meal is eaten in just 14 minutes and 27 seconds, less than half the more leisurely 33 minutes spent chewing and chatting 20 years ago. Of the people surveyed, eight in 10 said they regularly snack in front of the television, with one in five eating in front of a computer. Meals are also gobbled down while reading, sending text messages or talking on the phone, and fewer than two in 10 respondents said they regularly give their plates their full attention. Some 73% of Britons don't bother using a knife at mealtimes and 64% eat food straight out of its packaging. In today's hyper-efficient, fast-paced world, we often sacrifice that which made us human and which built our society: our fundamental need for food and the communality that was born of this need. This modern way of eating cannot provide humans with the biological or emotional sustenance they thrive on. I want to encourage you to rediscover the joys of eating calmly, at a table, using cutlery, ideally in the company of people you are fond of. Shared, leisurely meals are about much more than fueling our bodies, they are "uniquely human institutions where our species developed language and this thing we call culture," U.S. health writer Michael Pollan argues in an impassioned plea for

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a return to more traditional eating habits. "The shared meal elevates eating from a mechanical process of fueling our body to a ritual of family and community, from mere animal biology to an act of culture."

AdoptingaMediterraneanapproachtoeating

In recommending the Mediterranean diet, I want to move beyond the "food-asmedicine" paradigm, where food is seen merely as an amalgamation of molecules that support bodily functions and promote physical health (a mechanistic view popular in Anglo-Saxon countries). Instead, I espouse the more holistic ethos prevalent in Mediterranean cultures where food is also a source of spiritual nourishment, of pleasure, comfort and vitality ­ a celebration of life in the fullest sense. Although modern eating patterns have been making inroads into Mediterranean countries, many retain a rich and joyful food culture. Indeed, French bistros at lunchtime throng with office workers enjoying a leisurely meal and engaged in lively conversations rarely pertaining to work. On Sundays, three-generation families gather around many a dining table for at least two to three hours' eating, relaxing and laughter. These groups often include babies and toddlers who learn from an early age that eating with others is an occasion for joy and communality. Sociologists have compared habits of conviviality in Mediterranean and AngloSaxon countries and their results make fascinating reading. In an international survey of people's attitudes to food and eating, respondents were asked to describe what, to them, constituted a "healthy diet". Whereas primary health concerns for the Americans and Britons surveyed touched on notions such as "proteins," "carbohydrates" and "fat," Italian and French respondents overwhelmingly focused on the concept of pleasure. Indeed, during focus-group discussions, French participants mentioned the words "pleasure" and "joy" 79 times, whereas these terms came up only 16 times in the American group. There was also a great divergence in respondents' attitudes to conviviality: when asked what constitutes a healthy diet, French and French-speaking Swiss participants spoke spontaneously of "family meals" or "eating with friends." In the Frenchspeaking focus group, the word "family" came up 39 times, "friends" 51 times, "convivial" 72 times and "sharing" 38 times. This is in striking contrast with the Anglophone groups, where "family" was mentioned eight times, "friends" four times and "sharing" only three times. Lastly,

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while Anglophones and Germans valued "conviviality" on special occasions, the French, in particular, said they treasured conviviality as an ordinary, day-to-day event. In addition to their attachment to conviviality, the French and Italian respondents also adhered most closely to a strict set of rules about meal times (three times a day, at fixed times), portion sizes (modest), table manners (no phones, no TV), snacking between meals (forbidden), second helpings (frowned upon), dietary variety (essential), eating environments (tables, real dishes and cutlery, not cars, sidewalks or desks). Thus, "Mediterranean" anti-cancer eating isn't just about eating healthy food. It's also about consciously developing a health-promoting attitude to food. In recommending to you the Mediterranean diet, therefore, I refer also to its underlying philosophy, not just specific anti-cancer ingredients. I am talking about fresh, natural food grown nearby in living earth, under open skies, moistened by rain, ripened by the sun and brimming with essential nutrients, simply prepared and enjoyed in a relaxed mood, ideally in the joyful company of people you like! Indeed, this is very much in keeping with the spirit of Mediterranean culinary traditions, where dishes were rarely cooked in accordance with rigid rules and recipes, but rather, came together in an instinctive, organic way based on whatever ingredients were available and on the cook's ingenious ability to transform these into a simple yet tasty dish. Mediterranean cuisine is essentially an "anti-recipe"-cuisine; thus, the recipes in this book are meant less as rules to be adhered to and more as guidelines to be followed or disregarded as you please. Although I have taken a few cooking classes, I am not a formally trained chef, simply a self-taught home cook who has decided that, if I'm going to eat my way to good health, it might as well be a delicious, enjoyable experience. That's why I have put together this recipe collection. I have tested these recipes on my family and friends, my children and their friends, and am happy to report that they've gone down very well. I hope you will agree!

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Thesevencolorsofhealth

Colourandactive phytonutrient Red(lycopene) Foodsources Physiologicalfunctions Antioxidant,inducesenzymes thatprotectcellsagainst carcinogens;mayprotect againstprostateandlung cancers.

Tomatoes,pinkgrapefruit,water melon;processedtomatoes (tomatopaste,ketchup,soup, juice).

Red/Purple (anthocyanidins, proanthocyanidins, ellagicacid)

Redapples,redpeppers, blackberries,blueberries,red cabbage,cherries,cranberriesor cranberryjuice/sauce,eggplant, redgrapesorjuice,redpears, plums,pomegranates,prunes, strawberries,redwine. Carrots,mangos,apricots, cantaloupes,pumpkin,acorn squash,wintersquash,sweet potatoes. Orangejuice,oranges, tangerines,peaches,papayas, nectarines. Avocados,peppers(greenor yellow),collardgreens,sweetcorn, cucumber,greenbeans, honeydewmelon,kiwifruit, mustardgreens,peas,green romainelettuce,spinach,turnip greens,zucchini(withskin). Broccoli,Brusselssprouts,bok choy,cabbage,cauliflower,kale, Swisschard,watercress.

Antioxidant,anti-angiogenic, mayhelppreventthebinding ofcarcinogenstoDNA; mayprotectagainstgastrointestinalcancers.

Orange(alphaand betacarotenes)

Antioxidant,mayimprove communicationbetweencells; mayhelppreventlungcancer.

Orange/yellow (beta-cryptothanxin, aminorcarotenoid) Yellow/green (carotenoidslutein, zeaxanthin)

Antioxidant,mayinhibit cholesterolsynthesisneeded toactivatecancercellgrowth. HelpcorrectDNAimbalances; helpstimulateenzymesthat breakdowncarcinogens.

Green(sulforaphane, isothiocyanate, indoles)

Stimulatethereleaseof enzymesthatbreakdown cancer-causingchemicalsin theliver;mayinhibitearly tumorgrowth. Antioxidant,anti-tumor.

White/green(allicin fromtheonion family;flavonoids quercetinand kaempferol)

Garlic,onion,leek,celery, pears,endive,chives,artichokes,asparagus,mushrooms.

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Which sugars should we eat? There's no easy answer, but there's an honest one: no sugar is truly healthy. Until about 100 years ago, humans did not eat concentrated sugars several times a day and our organisms aren't well equipped to deal with this. However, some sweeteners are less damaging than others. Here are some suggestions for the least unhealthy way of adding sweetness to our food. · Wean yourself off sugar gradually: keep a food diary to track which sweet foods you eat, how much and how often. Next, slowly reduce the amount of sugar you put in drinks, the number of sodas you drink or the number of sweet snacks you eat. For example, over four weeks you can reduce the number of sugars in your coffee from three, to two, to one, to none. Train yourself to eat dark chocolate, starting with 60% cocoa content, then 65%, next 75%, then 85% and so on. After a while, the sugary foods you used to love will taste cloyingly sweet. · Sugar masks flavor and so, as you reduce your sugar intake, your taste buds will become increasingly sensitive to the satisfying flavor of naturally sweet food. After several weeks of conscious low-sugar eating, an apple or a pear can taste like the sweetest, most succulent treat on earth! Vegetables, too, can taste sweet ­ for example slow-roasted bell peppers or slowly caramelized onions, or pumpkin, peas, beets and carrots. For those who like crunchy snacks, raw nuts and seeds ­ almonds, cashews, pecans, walnuts or pumpkin seeds ­ may be a satisfying alternative to candy, though they should be eaten in moderation as they are rich in calories. · Honey in moderation. The most natural source of sugar is honey. Our ancient ancestors used it not so much as a sweetener, but as convalescent food and sacred medicine. This is not surprising: Honey has remarkable antioxidant, antimicrobial, tumor-killing and anti-inflammatory properties. Use raw honey that has not been heat-treated; the best place to find this is a health food shop or farmers' market. While most types of honey have high glycemic-index rankings, acacia honey ­ runny and delicately flavored ­ has a GI of 32. Acacia honey costs more than sugar, but since you'll be consuming very little (even honey is sugar, so eat it very sparingly), a little will go a long way! · Use natural sweeteners in small quantities. In the recipes in this book I have used the lowest amount of sweetener I felt I could get away with. If you do want to add an extra smidgen of honey to these recipes won't do much harm as sugar content will still be well below that of most conventional recipes, not to mention shop-bought desserts, cakes and cookies.

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· Other natural sugars, like dehydrated cane sugar or maple syrup, have GI ratings similar to those of table sugar. They are acceptable in moderation but have no therapeutic value. · Agave syrup and xylitol are two fashionable sweeteners with very low GI values. Both are derived from plants, but, unlike honey, they undergo substantial processing. They have other drawbacks: agave syrup, for one, contains as much as 90% fructose, which contributes to weight gain, heart disease and intestinal problems if eaten in large quantities. Moreover, a recent study found that pancreatic cancer cell growth was fuelled just as readily by fructose as by glucose. Xylitol, a sugar alcohol extracted from birch bark may cause bloating and can have a chemical aftertaste. In contrast to honey, neither of these sweeteners offers cancer-protective benefits; they are simply lower-glycemic alternatives to sugar. · Eat desserts as an occasional treat only, for example two to three times a week. Try eating stewed fruit after a meal and snack on fruit, nuts and seeds. A square of dark chocolate (minimum 70% cocoa content) after a meal can be very satisfying. · An effective strategy for preventing after-dinner sweet-snacking is to thoroughly brush, floss and rinse your teeth as soon as the meal is over. After all that time and effort spent on oral hygiene, you won't want to go through it all again for the sake of a few sugary snacks, will you? (The minty taste in your mouth will put you off food anyway.) · Getting enough sleep can help curb sugar cravings. When we feel fresh and rested in the morning, we are less likely to need to climb aboard the blood-sugar roller coaster (coffee, sweet pastries, sugary cereals, day-long snacking) than when we feel tired and irritable upon rising.

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When eating becomes a chore Cancer and its treatments put many people off their food. This is understandable; not only do many cancer patients feel anxious or depressed ­ emotional states that can suppress our appetite ­ but many cancer therapies also trigger physiological problems that make eating and digesting difficult. Chemotherapy or radiotherapy, for instance, can irritate the digestive tract from the mouth (soreness, metallic taste, sore throat, trouble swallowing) via the stomach (nausea, vomiting) to the intestines (bloating, constipation, diarrhea). Fatigue also affects many people undergoing cancer treatment, making it difficult for them to obtain and prepare foods from scratch. Getting help with shopping and food preparation when you are undergoing active treatment can be very helpful. During treatment, focus on eating whatever foods you can get down and keep down. These should ideally contain lots of nutrients, but if you crave the comfort of a chocolate chip cookie, enjoy one and let it lift your spirits. During active cancer treatment it is important to remain hydrated and consume enough nutrients to prevent weight loss and weakness. Some people find liquid or pureed foods ­ such as soups, smoothies, fresh vegetable and fruit juices or vegetable purees ­ easiest to eat and digest. Such foods fulfill the double function of hydration and optimum nutrition, and are generally quick and easy to prepare. Food safety during cancer treatment Clean, safe food is crucial for people undergoing cancer treatment as they are vulnerable to bacteria, viruses or other foreign substances that can crop up in food. If you are undergoing cancer treatment, or are cooking for someone who is, follow these simple guidelines: · Keep cold foods cold (below 40°F/4°C) and hot foods hot (above 180°F/80°C). · Wash fruits and vegetables thoroughly under running water before use. · Wash the tops of cans before opening. · Do not taste food that looks or smells strange. Do not eat food whose expiry date has passed. Avoid loosely packaged "street food" whose freshness you are not certain of. · Avoid raw fish, meat (especially poultry), eggs, dairy products and mayonnaise, which may be contaminated with bacteria. Cook these foods thoroughly. · Wash hands thoroughly before and after handling food and before eating.

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· Make sure all tools, cutting boards, cutlery and plates are cleaned thoroughly. Tea towels and dishcloths must be changed after every use. Tips for nausea, vomiting or sore mouth or throat: · Eat small, frequent meals, rather than fewer, larger meals. · Sip liquids ­ mainly water and herbal teas ­ throughout the day between meals but avoid drinking at meal times, which can exacerbate nausea. If you feel very nauseous, sip them slowly in small spoonfuls. · Ginger can help calm nausea; infuse coarsely chopped raw ginger in hot water and sip it lukewarm, at room temperature or chilled, perhaps flavored with lemon and a little honey. (Check with your doctor before using ginger.) Peppermint tea can also be stomach-soothing. · Eat under calm, relaxed conditions. Rest after meals, preferably in a sitting position. · Eat slowly and chew your food thoroughly to make it easier to digest. · If strong flavors or odors turn you off, eat bland foods such as lightly poached chicken breasts or white fish, plain brown rice or pasta and vegetables such as carrots, sweet potatoes, peas, green beans or zucchini. · Some people undergoing cancer treatment develop an aversion to the taste of red meat; replace this with lean poultry, fish and eggs to ensure sufficient protein intake. · Wear comfortable, loose-fitting clothing. · Get fresh air in your lungs by keeping your home well-aired and taking gentle walks with deep breathing. Yoga breathing exercises may help. · Avoid eating hard-to-digest foods (fatty, meaty, fried or spicy dishes, for example). · In case of vomiting, make sure you get enough liquids in the form of water, herbal infusions or fruit and vegetable soups and smoothies. If vomiting lasts longer than ½ hour, call your doctor. · If you have sore gums, apply honey and leave for several minutes before swallowing. · If head and neck radiotherapy is making your throat feel sore, have some honey before and after your treatment. One study showed that people who slowly swallowed four teaspoons of honey 15 minutes before and after treatment experienced significantly reduced oral mucositis ­ severely sore throat ­ than those rinsing with a saline solution, and also lost less weight. Honey has many applications in cancer care; applied topically, it can promote the healing of radiation burns, chemotherapy-induced skin problems and surgical wounds.

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Tips for people suffering from constipation: · Keep well-hydrated; sip six to eight glasses of water and herbal infusions throughout the day. · Eat fiber-rich foods ­ especially fruits and vegetables ­ at every meal. Whole grains, nuts and seeds can help too, but avoid wheat bran as it is hard on the intestines. If you have trouble chewing try grating, pureeing or blending your food. · Stewed prunes can help set things in motion. · Ground flax seed in soups, smoothies, cereals or baked goods can help promote bowel motility. · Get as much light exercise, such as walking, as your health permits. · Eat plain, live yogurt daily to help restore a healthy gut flora. Tips for people suffering from diarrhea: · Again, drink plenty of liquids to prevent dehydration; sip about eight glasses of water and herbal infusions throughout the day. · Consume plenty of liquids and foods containing potassium and sodium, such as vegetable broth, bananas, green leafy vegetables, mushrooms, celery, broccoli or squash. · Temporarily reduce your intake of high-fiber foods (fresh vegetables, fruit, whole grains) and opt for apple or quince purees, rice and rice water, pasta and white toast until the diarrhea has stopped. Then return to your usual fiber-rich diet. · Eat plain, live yogurt or kefir daily to help maintain a healthy gut flora; if you find this hard to keep down, ask your doctor to recommend a probiotic supplement. · Avoid fatty foods or large amounts of protein in a single meal. Having discussed in some detail all the foods that can boost our health, let's take a closer look at how we can fit these into our busy day-to-day lives.

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Mediterranean Anti-Cancer Recipes

A selection of 12 recipes from a total of 150 in the full-length book

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Avocado, tomato and tofu tricolora salad

InspiredbyItaly's insalata tricolora,(tomatoes,mozzarella andbasil)thislighthors d'oeuvrebrimswithsummeraromas: spicytomatoes,sweetbasil,fruityoliveoil,fragrantbalsamic vinegarandnuttypinenuts.Theinnovationistofuinsteadof mozzarella.Serves4.

3.5oz/100g firm tofu, sliced and marinated overnight in 2 tbsp basil pesto 3-4 firm tomatoes 1 ripe but firm avocado 2oz/50 g pine nuts olive oil 1 tbsp balsamic vinegar 15 basil leaves, roughly torn or shredded salt & freshly ground black pepper

Slice tofu into ¼-inch/5mm slices and place in a container with a lid. Add pesto (perhaps diluted with a little water to make it runnier) and combine, ensuring that the tofu is well coated with the pesto. Seal and refrigerate for several hours, or ideally overnight. When you are ready to prepare the salad, slice the tomatoes with a sharp knife, taking care to remove the fibrous core. Halve the avocado, remove the stone, halve again, peel quarters carefully and slice. In a dry pan on low heat, toast pine nuts until golden and fragrant (2-3 minutes). Transfer to a bowl to cool. Arrange tomatoes, avocado and marinated tofu on a large serving plate. Drizzle with olive oil and balsamic vinegar, scatter with pine nuts and basil leaves and season lightly with salt and freshly ground black pepper. Serve immediately.

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Red cabbage and walnut slaw

Acrunchy,fruityanddramaticallycoloredsaladforthose drearywintermonths­thismakesapleasant(andlighter) changefromtraditionalcoleslawwithmayonnaise!

½ red cabbage, quartered, cored and finely sliced by hand or food processor 1 large apple (peeled if non-organic), finely grated 1 shallot, finely chopped 2 tbsp apple cider or red wine vinegar 2 tbsp raisins 2oz/50g walnuts, coarsely chopped 2 tbsp walnut oil 2 tbsp olive oil salt, pepper

In a salad bowl, combine chopped shallot and vinegar and leave to infuse five minutes. Then add oil, salt and pepper. Add shredded cabbage, grated apple and raisins and toss with dressing; if you have time, leave to infuse for ½ hour. Sprinkle with walnuts and serve.

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Moroccan chicken & garbanzo soup

Thiswell-knowndish(calledchorbainArabic)isanourishing NorthAfricanstewofteneatenjustbeforesunriseduring Ramadan,theIslamicmonthoffasting.Aswithsomany Mediterraneanstews,thereareasmanyversionsofchorbaas therearecooks­somepreparedwithlamb,otherswithveal, somecontainingvermicellinoodles,otherspotatoes.Feelfree toaddothervegetablessuchasgreenbeans,choppedfresh spinach,turnipsorzucchini,dependingontheseasonandon yourmood.However,thegarbanzosshouldremainasthey givethesoupbulkandbite;ifyoulike,youcanreplacethe chickenwithsmallcubesoffirmtofu.Serves4.

3 tbsp olive oil 1.1lb/500g chicken leg portions 2 large onions, chopped 1 rib celery, cubed 1 tbsp freshly grated or dried, ground ginger 3 cloves garlic 1 tsp turmeric 1 tsp ground coriander

In a large, heavy cooking pot, warm 1 tablespoon olive oil and cook the chicken portions on gentle heat until golden on both sides. Remove and set aside. Add remaining olive oil and cook onion, celery and garlic until the onions are translucent. Add ginger and spices and cook for another minute, stirring to prevent the spices burning. Add stock and carrots or pumpkin, and bring to a boil. Return chicken portions to the pot, add garbanzos and bring back to the boil; then reduce heat and simmer on low heat for 20 minutes. Add tomatoes and continue cooking for 15-20 minutes, until the vegetables are soft and the chicken is cooked through. Remove chicken, discard skin, shred into bite-sized pieces and return to stew to reheat. Season to taste with lemon zest and juice, salt and pepper and sprinkle with chopped cilantro leaves.

½ tsp ground cumin ½ tsp paprika powder pinch of saffron 1 cinnamon stick pinch of chili powder 7oz/200g cubed pumpkin or carrots 15oz/400g cooked garbanzos, drained 15oz/400g cubed tomatoes (fresh or from a jar) 2 pints/1l chicken stock zest and juice of ½ lemon 3 tbsp chopped cilantro salt & freshly ground black pepper

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Chilled minty cucumber soup

Onahotsummer'sday,themerethoughtofthispale-green, mintyconcoctionwillsendcoolwavesthroughyou.What's more,youwon'tworkupasweatmakingitasitisreadyina matterofminutesandthereisnext-to-nocookinginvolved! Serves4.

1 large cucumber, cubed 7oz/200g plain yogurt 2oz/50g ground almonds 1 small apple, peeled, cored and cubed 1 clove garlic, crushed ½ bunch of mint (about 5-6 stalks) zest and juice of ½ lemon 3 tbsp olive oil salt & freshly ground black pepper 2 tbsp almond slivers pinch red pepper flakes or paprika powder

In a dry skillet and on low heat, lightly toast almond slivers for 1-2 minutes until barely golden. Transfer to a plate to cool. Pick the mint leaves off the stalks, set a few aside for garnish and place the rest in a blender along with yogurt, cucumber, lemon juice and zest, almonds, crushed garlic and apple. Blend until smooth and light green. Adjust seasoning to taste. Chill for at least 1 hour; this allows the flavors to deepen. Serve in individual bowls or glasses decorated with mint leaves. Sprinkle lightly with pepper flakes or paprika powder and toasted almond slivers. For extra cooling effect, add 1-2 ice cubes per glass. Variation You can replace the mint with dill and garnish the soup with a teaspoonful of pink salmon roe for a Scandinavian touch.

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Cherry tomato pie

Clafoutis,aclassicFrenchdish,ismostwidelyknowninits originalincarnationasasweetcherrypie.Thissavoryversion makesaquickandeasysummerlunchwhentomatoesare sweetandaromatic,andjuicyherbsabound.Tastesgreatwith WarmPuylentilsaladorwithalightlytossedgreensalad. Serves4.

15oz/400g cherry tomatoes, washed and patted dry 12fl oz/1½ cups/350ml unsweetened almond or soy milk 7oz/200g feta cheese, crumbled 4 eggs large pinch of turmeric (to taste) 2 tbsp corn starch 2 tbsp chopped chives or basil leaves salt & freshly ground black pepper some olive oil for the pie dish

Preheat oven to 350°F/180°C. Oil oven-proof ceramic dish and place cherry tomatoes and crumbled feta cheese in it. In a bowl, whisk corn starch with milk and eggs. Add half the chopped herbs and turmeric and combine into a smooth, creamy batter. Season with salt and pepper. Pour egg mixture gently over tomatoes and feta cheese and slide the pie dish into the oven. Bake for approximately 30 minutes. The clafoutis is ready when the custard has risen and is a golden color. Remove from the oven, sprinkle with remaining herbs and serve immediately.

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Greek fish and vegetable bake

OneofthemostpopularwaysofpreparingfishinGreece,this dish(knownasplaki)iseatenhotinwinter,orlukewarmor coldasarefreshingsummermeal.Leavingittositforafew hoursaftercookingallowstheflavorstoinfuseanddeepen. Serves4.

3 tbsp olive oil 2 onions, halved and thinly sliced 2 cloves garlic, coarsely chopped 1 rib celery, finely cubed 2 carrots, finely cubed 2fl oz/¼ cup/60ml water or vegetable stock 2fl oz/¼ cup/60ml white wine 2 tomatoes, chopped (or ½ 15 oz/400g jar of tomatoes) pinch of oregano 1.3lb/600 g firm white fish cut into steaks or fillets 10-12 coarsely chopped green or black olives 3 thin slices untreated lemon 2 tbsp chopped parsley salt & freshly ground black pepper

Preheat oven to 350°F/180°C. In a medium pot soften the onions in the olive oil for 5 minutes. Add garlic, celery, carrots, water, wine, salt and pepper. Cover and simmer for 10 minutes until the carrots are al dente, then add tomatoes and oregano and cook another 5 minutes, covered. Lay fish steaks or fillets in a lightly oiled ovenproof dish, pour the sauce over it, scatter with chopped olives, lay lemon slices on top and cover with foil. Slide into oven and cook for 30 minutes or until the fish flakes easily when prodded with a sharp kitchen knife. Remove from oven, leave to cool for 5 minutes (if eating hot), sprinkle with parsley and serve. Alternatively, cool and serve at room temperature. Variation For a complete meal, I sometimes place a layer of cooked Garlicky spinach under the fish and bake the whole lot together.

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Lentil moussaka

ThisdishisinspiredbythefamousGreekMoussaka me melitzanes,butthenameiswherethesimilarityends.First, IhavereplacedfattylambwithnuttyFrenchgreenlentils. Secondly,Idonotsautétheeggplantslicesinoil,butbrush themlightlywitholiveoilandgrillthem,thususingmuchless oilandlighteningupthedish.Serves4-6.

1.3lb/2 cups/600 g cooked French green lentils 2fl oz/¼ cup/60ml olive oil plus 3 tbsp 3 large eggplants cut into 6-7 mm slices 2 onions, sliced 2 cloves garlic, chopped 1¾ lb/800g tomatoes, cubed 1oz/25g dried porcini or shiitake mushrooms, rehydrated, drained and finely chopped 3.5fl oz/½ cup/120ml red wine 3 bay leaves 1 tsp thyme 1 tbsp each of oregano and mint 1 tsp cinnamon 13.5fl oz/1 cups/400ml unsweetened soy or almond milk 2 tbsp whole wheat or spelt flour 2 tbsp olive oil 1 tsp turmeric pinch of grated nutmeg salt & pepper

Warm 2 tablespoons of the oil in a large pot on medium heat and gently cook onions and garlic until translucent (about 4-5 minutes). Add herbs and cinnamon, tomatoes, mushrooms and red wine and cook uncovered for 20 minutes until reduced by about one third; puree with a hand-held blender. Add cooked lentils to the tomato sauce and cook for another 15 minutes. Remove from heat. While the lentil sauce is cooking, lightly brush both sides of the eggplant slices with olive oil and place on a baking tray covered with baking parchment. Set grill on medium heat and grill eggplant slices on both sides until golden. Set aside. For the béchamel topping, put cold milk, olive oil, flour, turmeric and nutmeg in a pot and whisk until combined. Set over medium heat and stir. After 2-3 minutes the mixture will start thickening; keep stirring until it bubbles gently. Cook another 1-2 minutes, stirring all the while. Remove from heat. Lightly oil an ovenproof dish and get ready to layer. Start with a thin layer of lentil-tomato sauce followed by a layer of eggplant and continue in this way until you end with lentils on top. Finish by pouring the béchamel over the pie and smoothing it out evenly with a spatula. Place in a preheated oven and cook for 15 minutes; sprinkle with crumbled feta cheese and cook another 10 minutes until the cheese is golden. Serve.

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Mushroom orzotto

AspecialtyfromnorthernItaly,thisispreparedlikeaclassic risotto,onlyusingbarley(orzoinItalian)insteadofrice.This substitutionaffordsmanyadvantages,forbarleyisrichin anti-cancernutrients,suchasseleniumandlignans,aswell assolublefiber.ItalsohasalowerGIratingthanmosttypes ofrice.Barleyneedstobesoakedovernight;thismakesit easiertodigestandfastertocook.Whenbuyingbarley,always choosehulledoverpotorpearledbarleywhichundergomore processingandarelessnutritious.Serves4.

7oz/1 cup/200g hulled barley, soaked for 12 hours and drained 2 tbsp olive oil 1 onion, finely chopped 4 cloves garlic, finely chopped 1.1lb/500g mushrooms (e.g. button, chestnut, oyster, shiitake), sliced 1oz/25g dried mushrooms, rehydrated in warm water for 15 minutes ½ tsp thyme 1 pints/3 ½ cups/800ml vegetable or chicken stock 2-3 tbsp dry white wine 2 tbsp chopped parsley squeeze of lemon juice salt & freshly ground black pepper 1 tbsp butter grated Parmesan or pecorino cheese

In a large skillet on medium heat, warm a tablespoon of olive oil and cook garlic, fresh and rehydrated mushrooms and thyme, stirring regularly, until soft (about 10 minutes). In a heavy-bottomed pot, heat another tablespoon olive oil on medium heat and gently cook the chopped onion, stirring regularly until it is translucent. Add barley and cook for a minute. Now begin adding stock, ladle by ladle, and keep stirring while the barley grains slowly absorb the liquid. After about 20 minutes of ladling and stirring you should have used up all the stock. The barley grains will have roughly doubled in volume and the mixture will be creamy. Now add cooked mushrooms and a splash of white wine and cook, stirring, for another 2-3 minutes. If the mixture appears too firm or sticky, add a little more stock, wine or water. Test the grains: they should be soft but slightly chewy. Season with salt, pepper and lemon juice. Stir in the butter, transfer to a serving dish and sprinkle with grated cheese. Variations · For added protein, add cubed, firm tofu or leftover chicken. · For a splash of color, stir in some baby spinach leaves, arugula or other fast-wilting greens a minute or two before serving.

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Sicilian eggplant stew

OneofSicily'sbest-knowndishesiscaponata,adelicious sweet-and-sourstewofmeltinglysofteggplants,crunchy celeryandpinenutsbroughttogetherbyfruitytomatoesand roundedoffwithfragrantbasil.Serves4asasidedishorhors d'oeuvre.

1 onion, quartered and sliced 4 ribs celery, sliced 2 eggplants, diced 15oz/400g tomatoes, chopped 5 tbsp olive oil 12 black olives, sliced 2 tbsp red wine vinegar 1 tbsp acacia honey 2 tbsp capers 2 tbsp chopped basil or parsley 2 tbsp lightly toasted pine nuts salt & freshly ground black pepper

In a large, heavy-bottomed skillet, heat 2 tablespoons olive oil and cook onion and celery for 5 minutes, stirring regularly until translucent. Add eggplant cubes and remaining olive oil and continue cooking until the eggplant starts to turn golden (about 10 minutes), turning the vegetables occasionally with a spatula to prevent them sticking to the pan. Add tomatoes, olives, vinegar, capers and honey and cover, simmering on a low heat for another 15 minutes. Just before serving, season to taste with salt and pepper, then sprinkle with basil and pine nuts. This can be enjoyed warm or cold, on its own or accompanied by eggs, fish, lean meat or plain steamed bulgur or brown rice.

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Homemade tomato ketchup

Ifyouthinkmakingyourownketchupisalittleover-thetop,considertheadvantages.Notonlyareyouavoidingthe drawbacksofmass-producedketchup­excesssugar,salt andvariousadditives.Inaddition,thisketchupenablesyou toconsumesmallbutregulardosesofanti-cancerspices andfoodsthroughouttheday!Enjoyasmallblobwithyour breakfastegg,anotheronyourlunchboxsandwichanda thirdwithfishorchickenfordinner­amongcountlessother options.Makesabout2pints/1l.

2 tbsp olive oil 1 onion, chopped ½ tsp gingerbread spice (or a generous pinch each of ginger, cloves, cinnamon and nutmeg) 1 tsp turmeric 1¾lb/800g tomatoes, chopped 3.5oz/ cup/100g dried apricots, chopped 3 tbsp tomato paste 2 tbsp apple cider vinegar 1 tbsp acacia honey (optional) salt & freshly ground black pepper

In a medium-sized pot on medium heat, gently cook the onion in olive oil until translucent. Add spices and cook for another minute, stirring continually. Now add tomatoes, tomato paste, apricots, vinegar, salt and pepper. Bring to the boil, then reduce heat and cook for 30 minutes on the lowest setting. If using tomatoes from a jar, cover with a lid. If using fresh tomatoes (these generally contain more water), leave uncovered so that excess moisture can evaporate. Transfer to a blender and liquidize to obtain a smooth, thick puree. If it is too thick, add a little water or apple juice. For an extra-smooth sauce, pass through a sieve. Season with a little more salt, vinegar and honey if necessary. Fill into an empty, thoroughly cleaned glass bottle. Wellsealed, this keeps in the refrigerator for at least two weeks.

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Almond waffles with blueberry sauce

Forpeopletryingtoweanthemselvesoffprocessedorstarchy breakfastfoods,here'samorningdishthat'slightyetfilling andrichinhealthyfatsandproteintohelpstabilizebloodsugarlevels.Thesecanbemadeinadvance,frozen(separated withsmallsheetsofbakingparchment)anddefrostedunder thegrill.Makes4-6waffles,dependingonthesizeofyour waffleiron.

2 eggs 4.5oz/1 ½ cups/125g ground almonds 4.5oz/1 cup/125g whole spelt or wheat flour 1 heaped tsp baking powder 1 tsp natural vanilla extract 10fl oz/1¼ cups/300ml milk (almond, hazelnut, soy or dairy) pinch of salt

Start by making the blueberry sauce (this can be done in advance). Combine juice and corn starch in a medium pot and bring to the boil; stir until the juice has thickened. Remove from heat, add blueberries, lemon zest and honey. Stir well and set aside to cool. Keeps for a week chilled in a tightly sealed container. In a mixing bowl, combine all the waffle ingredients and whisk until you obtain a smooth, thick batter. Heat waffle iron and bake the waffles as directed by the machine's instructions. Cool for a minute on a wire rack and serve with the blueberry sauce. Variations · This recipe works equally well with ground hazelnuts in the place of almonds and 1 teaspoon cinnamon instead of vanilla extract. Topped with apple sauce, this makes a delicious winter breakfast. · Add 1 tablespoon each of pure cocoa powder and honey to the batter for chocolate waffles.

Blueberry sauce

1.1lb/500g blueberries (fresh or defrosted) pinch of grated lemon zest (untreated) 3.5fl oz/scant ½ cup/100ml red berry juice (e.g. blueberry, cherry, raspberry) 1 heaped tbsp corn starch mixed with 2-3 tbsp water or apple juice 2 tbsp honey

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Very berry summer pudding

It'shardtoimagineamoreconcentrated­ordelicious­way ofenjoyingourred,blueandpurplefriends,theberriesand cherries.Thisisalsoagreatwaytogetchildrentoeatberries, which,ontheirown,theyoftenfindtootart.Whileitisbestto eatfruitsandvegetablesduringtheirlocalgrowingseason,we canmakeanexceptionhere:theberryseasonbeingwoefully shortandfreshberriesoftenexpensive,I'mhappytomakethis withfrozenberriesandenjoyitallyearround.Serves4.

1.1lb/500g mixed pitted cherries and berries (raspberries, strawberries, blueberries, cranberries, red- and blackcurrants, blackberries, gooseberries etc.), fresh or frozen 7fl oz/scant 1 cup/200ml cherry or red berry juice (or a combination of 4fl oz/½ cup/120ml juice and 2.5fl oz/1/3 cup/80ml red wine for a more grownup version) 2 tbsp corn starch grated zest of ½ lemon (untreated) 3-4 tbsp acacia honey (more or less to taste) some mint leaves for decoration

If using frozen berries, scatter onto a large tray or platter and defrost (about 30 minutes). Pour juice (or juice/wine mixture, whichever using) into a medium pot, add corn starch, lemon zest and honey and mix. Over medium heat, bring the liquid to a simmer, stirring continually with a balloon whisk until it thickens. Remove from heat, tip in the defrosted berries and stir gently with a spoon to coat these evenly with the thickened juice. Adjust sweetness with honey, one spoonful at a time, Spoon into a serving bowl (this looks particularly attractive in a glass bowl) or individual glasses and cool. Decorate with mint leaves and serve at room temperature or chilled. If you like, you can serve this with Vanilla cashew cream or topped with plain yogurt thinned with a little milk and flavored with honey and vanilla.

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Appendix 3 Weeky meal planner

Tuesday Wednesday Thursday Friday Saturday Sunday

Monday

Breakfast

Snack

Lunch

Snack

Dinner

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Appendix 4 Shopping list

Tick or underline the foods you need, specifying quantity. Write any additional items in the blank spaces.

Fruits and vegetables

(Buy local and seasonal produce; don't buy too much at once as storage reduces nutritional value.

Store cupboard items, dry goods

F Dried beans and lentils F Herbs (specify) F Spices (specify) F Salt, pepper F Dried fruit (prunes, apricots, apple rings, cherries, blueberries, etc.) F Tea, coffee F Dried mushrooms F 100% cocoa powder F Dark chocolate (70% cocoa content or more) F Whole grains (e.g. barley, spelt, oats, etc.) F Whole flakes F Flour (e.g. spelt, wheat, corn, etc.) F Wholegrain pasta F F F

Fresh foods (refrigerator)

F Omega-3-rich eggs F Meat / fish F Plain yoghurt F Milk / butter / cheese from grass-fed animals (in moderation) F Nuts and seeds (walnuts, cashews, Brazils, hazelnuts, almonds, pumpkin seeds, etc.) F Tofu requiring refrigeration (e.g. silken tofu, plain firm tofu) F Cold pressed oil (e.g. walnut) F Sauces / spreads F F F

Store cupboard items (in jars, cartons, tins or bottles)

F Milk & cream (nut/soy/dairy) F Soy sauce, balsamic or red wine vinegar F Unsweetened coconut milk and cream F Beans, tomatoes, mushrooms, olives etc) in jars F Pesto, salsa, tapenade (minimally processed) F Sundried tomatoes, F Tomato concentrate F Unsweetened fruit compotes F Fruit spreads without added sugar F Fish (sardines, mackerel, herring, anchovy) in cans or jars F F F

Frozen foods

F Frozen berries (e.g. blueberries, raspberries, berry mixes) FOther frozen fruit (e.g. apricots, peaches, mangoes, etc.) FFrozen vegetables (e.g. peas, beans, carrots, broccoli, cauliflower, leaf spinach, onions, artichoke hearts, plain grilled peppers and eggplant slices, etc.)

ZestforLife39

Zest for Life, The Mediterranean Anti-Cancer Diet can be purchased at all major bookstores, including www. amazon.com and www.barnesandnoble.com in the US and www.amazon.co.uk and www.waterstones. com in the UK. It is also available as an electronic book on Kindle and other eBook outlets. Zest for Life is supported by a website, www.zestforlifediet.com with a regularly updated cancerprevention blog, photographs of some recipes in the book and cookery instruction videos. Twenty-five percent of author royalties are donated to UK cancer charity Maggie's Cancer Caring Centres. For more information, see www.maggiescentres.org/home.html

This publication contains the opinions and ideas of its author. It is intended to provide helpful and informative material on the subjects addressed in the publication. It is sold with the understanding that the author is not engaged in rendering medical, health or any other kind of personal or professional services in the book. If the reader requires personal medical, health or other assistance or advice, a competent health professional should be consulted. Although every care and precaution has been taken in the preparation of this book, the author and publisher specifically disclaim all responsibility for any liability, loss or risk, personal or otherwise, that is incurred as a consequence, directly or indirectly, of the use and application of any of the contents of this book. Before undertaking significant dietary or lifestyle changes, including a weight-loss plan, or beginning or modifying an exercise program, check with your doctor if these changes are right for you.

This document is not intended for sale; it is available for free dissemination by anybody wishing to support the health of their patients, friends and loved ones.

Copyright © 2011 Conner Middelmann-Whitney Honeybourne Publishing Ltd Level 2 1 Sun Street London EC2A 2EP United Kingdom ISBN 978-0-9568665-0-9

Author Conner Middelmann-Whitney can be contacted at [email protected] Her website address is www.nutrelan.com; she provides Skype-based nutrition consultations at conner.middelmann.whitney

ZestforLife40

A share of the proceeds from this book is donated to cancer charities

Zest for Life ­ The Mediterranean Anti-Cancer Diet provides all the guidance and practical advice needed to make easy, delicious meals to help boost our defences against cancer. Inspired by rich and healthy culinary traditions from around the Mediterranean ­ Italy, France, Spain, Greece, Turkey, Morocco and others ­ Zest for Life celebrates the restorative powers of eating well, with an emphasis on fresh, varied foods, simple preparations and conviviality. Science-based nutrition guide and cookbook in one, Zest for Life comprises:

· · ·

A clear and practical explanation of the food-cancer link Step-by-step guidelines for gathering ingredients and planning meals Over 150 delicious, easy, affordable and mostly vegetarian recipes

The book is supported by a website, www.zestforlifediet.com, featuring cancerprevention news, healthy eating advice and culinary tips.

Conner Middelmann-Whitney is a nutritionist, cooking instructor and health writer. Ten years ago she overcame early-stage cervical cancer and has been a passionate advocate of cancer prevention ever since. A mother of three, she is based near Toulouse, France. Her website can be found at www.nutrelan.com.

41 ZestforLife

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